How to Help Kids With Asthma Breathe Better During the Wildfires

Toddler and mother at doctor's office

With the recent wildfires, what is in the air we breathe is a fear for many. Children with asthma are particularly vulnerable, so Stanford Medicine Children’s Health pediatrician Amy Oro, MD, shared some advice for concerned parents.   

How smoke can affect kids with asthma

A gray sky normally means rain clouds. But this summer it meant something more worrisome: wildfire smoke. Smoky skies pose a danger in several ways. The smoke is full of particles that can make it hard to breathe and trigger symptoms even for a healthy person.

“When smoke enters into the lungs, it causes irritation and muscle spasms of the smooth muscle that is around the small breathing tubes in the lungs,” Dr. Oro explained. “This can lead to difficulty with breathing and wheezing. It’s really difficult on the lungs.”

On top of that, those particles can be full of unhealthy chemicals.

“There are more than 400 toxins that are present in wildfire smoke,” she added. “That can activate the immune system in ways that aren’t helpful by both causing an inflammatory response and distracting the immune system from fighting infection.”

Ways to limit exposure to unhealthy air

  • Stay indoors. One way to know if it is safe to play outdoors is to check the Air Quality Index (AQI) at For kids with asthma, an AQI of 100 or more may mean you’ll have to postpone that trip to the park. “If you’re being told to stay indoors, listen. If you can, keep the windows and doors closed,” Dr. Oro said.
  • Keep the air at home clean. When staying indoors, it’s important to remember that using your fireplace, air fresheners, smoking, and some cleaning products can hurt the indoor air quality, according to the Environmental Protection Agency (EPA). By avoiding these and using an air purifier with a HEPA filter, you can clean the pollutants in the air inside your home.

Dr. Oro’s family has asthma, so they built their own purifier using a hack from an article in the New York Times. It consisted of a box fan with a HEPA furnace filter taped to the front. “It was pretty disgusting what we accumulated in the first 20 hours in our fan,” she said.

  • Limit exercise outdoors. Wearing a mask can help prevent the spread of diseases. However, more protection is needed when the air quality is poor. Outdoor exercise should be avoided at these times.

“Unfortunately, cloth masks don’t do very much [to protect you from the smoke pollution],” Dr. Oro said. “You really need an N95 mask, and most of those have been allocated toward essential workers.”

Exposure to high levels of air pollution can affect your immune system. If your body has an immune response to smoky or smoggy air, it’s harder for it to fight off viruses like COVID-19. The best way to prevent this is to stay away from areas with unhealthy air quality.  

Keep asthma medicines and health supplies stocked

Consider checking with your family pediatrician if your child takes an asthma medication. He or she may want to change the dose or schedule to prevent an asthma attack. It’s also a good time to make sure you have enough medication on hand for your child in case of a flare-up.

According to Dr. Oro, having a pulse oximeter or stethoscope at home could be helpful when it comes to telehealth visits.  

The good news is that wildfires are temporary. Once the air returns to normal conditions, children can go back to playing outside in the fresh air. If your child does have ill effects from the smoky air, call your pediatrician.

“A lot of what we’ve seen is that the smoke really adversely affects adults, especially older adults over 65,” Dr. Oro said. “Children tend to be really resilient.”


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